Knee Replacement Outcome Data Fall Short

Long-term data on total knee replacement surgery is largely limited to revision, leaving clinicians and patients in the dark about outcomes such as residual pain and disability, researchers said.

Currently the best data come from national procedure registries, but the traditional outcome measure is subsequent revision surgery, which "can underestimate problems [because] patients can remain with pain or poor function without necessarily undergoing revision," according to Andrew J. Carr, FMedSci, of the University of Oxford in England, and colleagues.

More than 600,000 knee replacement procedures are performed in the U.S. annually, according to the Agency for Healthcare Research and Quality.

Writing online in The Lancet (PDF), Carr and colleagues outlined four directions for the future of knee replacement surgery:

More consistent patient selection for knee replacement

Long-term monitoring with patient-oriented outcomes, as well as revision, as endpoints

Approval of new designs only after large randomized trials that demonstrate cost-effectiveness as well as clinical efficacy

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